Background-Hot flashes, and other symptoms of estrogen withdrawal, are common in breast cancer survivors, for whom hormone replacement therapy is contraindicated. Homeopathic medicines have been used to treat menopausal symptoms for more than 100 years. Objectives-A pilot study to determine if homeopathy may be effective in improving hot flashes and quality of life in breast cancer survivors with symptoms of estrogen withdrawal. Methods- A randomized double-blind placebo controlled trial of 83 breast cancer survivors with at least 3 hot flashes per day for at least one month was carried out. Subjects were randomized to one of three treatment arms: a single individualized homeopathic remedy, a combination homeopathic remedy, or placebo. Number and severity of hot flashes, menopausal symptom score, general health status, and health care utilization were measured over a 12-month period. Results/Significance- There was a positive trend towards fewer hot flashes in the group receiving the single remedy during the first three months of the study. Subjects not on tamoxifen receiving the combination remedy experienced a statistically significant increase in hot flashes. General health scores improved significantly in both homeopathy groups compared to placebo. Results of this study suggest that a larger study should be done.